The natural history of the cervical foramen in symptomatic and asymptomatic individuals aged 20-60 years as measured by magnetic resonance imaging. A descriptive approach.

Abstract

STUDY DESIGN:

This study was intended to identify normal degenerative morphologic evolution in the bony foramen in asymptomatic subjects by decade in comparison with symptomatic subjects of like decades.

OBJECTIVES:

To determine normal degenerative changes in the cervical spine caused by the aging process that predispose a person to foraminal stenosis and radiculopathy.

SUMMARY OF BACKGROUND DATA:

Cervical radiculopathy is a common problem caused by degenerative changes as people age. The characteristics of the foramen that result in stenosis are not known.

METHODS:

Five to six symptomatic and asymptomatic people in each decade volunteered for magnetic resonance imaging. Lordosis, disc heights, and ratio of spinal cord diameter to spinal canal diameter were measured at C4-C5, C5-C6, and C6-C7 from sagittal magnetic resonance images. Foraminal heights, widths, and areas were measured at the isthmus of the same foramen from oblique images.

RESULTS:

Foraminal heights, widths, and areas were larger in asymptomatic patients than in symptomatic patients. Morphologic analysis showed that inferior facet hypertrophy tended to decrease the width of the foramen in aging people. Disc heights, lordosis, and ratio of spinal cord diameter to spinal canal diameter showed no significant differences.

CONCLUSIONS:

Foraminal height affects overall foraminal area but tends to change little with age. Width also affects overall area and not only decreases in older people but also significantly affects the available area for the exiting nerve root.